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054.00.54-4. WCIP DEFINITIONS

AR ADC 054.00.54-4Arkansas Administrative Code

West's Arkansas Administrative Code
Title 054. Insurance Department
Division 00.
Rule 54. Arkansas Workers' Compensation Insurance Plan
Ark. Admin. Code 054.00.54-4
054.00.54-4. WCIP DEFINITIONS
A. “Affiliated Insurer” An insurer that directly, or indirectly through one (1) or more intermediaries, controls, or is controlled by, or is under common control with another insurer specified. The term “control” means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of an insurer, whether through the ownership of voting securities, by contract, or otherwise. Control shall be deemed to exist if any person or business enterprise, directly or indirectly, owns, controls, holds with the power to vote, or holds proxies, representing ten (10) percent or more of the voting securities of any other insurer.
B. “Articles of Agreement” or “Articles” The reinsurance mechanism authorized under this Plan to provide reinsurance to the servicing carriers on employers assigned to them under this Plan, which said agreement and any amendments thereto shall be provided to and approved by the Commissioner but which, in cases of conflict between them and this Rule and Regulation, shall be subordinate to this Rule and Regulation.
C. “Assigned Carrier” or “Servicing Carrier” The insurer authorized to receive Plan assignments and provide coverage to eligible employers on behalf of those participating companies subscribing to the Articles of Agreement incorporated as a part of the Plan in this state.
D. “Collected Premium” The gross direct premium charged and physically collected and receipted for all employers subject to this Plan.
E. “Commissioner” The Insurance Commissioner for the State of Arkansas.
F. “Employer” Any business organization or enterprise that is required by statute to maintain workers compensation insurance in this State. The term shall include any business organizations or enterprises that are affiliated as a result of common management or common ownership.
G. “National Council on Compensation Insurance, Inc.” or “NCCI” The rating organization or advisory organization licensed in this State to make and file rates, rating values, classifications, and rating plans for workers' compensation insurance.
H. “Net Premiums Written” The gross direct premiums charged less all premiums (except dividends and savings refunded under participating policies) returned to insureds for all Workers Compensation and Occupational Disease Insurance, exclusive of premiums for employers subject to this Plan, and for employers written under the National Defense Projects Rating Plan and under excess policies.
I. “Plan” or “WCIP” The Arkansas Workers' Compensation Insurance Plan.
J. “Plan Administrator” Such organization or organizations to which the responsibility for administering the affairs of the Plan may, from time to time, be delegated, including but not limited to such functions and duties as rates, forms, and statistics.
K. “Premium in Dispute” A workers' compensation insurance premium obligation in which a bona fide dispute exists only if the employer or its representative has provided:
(a) written notice to the insurer or the servicing carrier detailing the specific areas of dispute;
(b) an estimate of the premium the employer believes to be correct, with an explanation of the premium calculation;
(c) payment of the undisputed portion of the premium; and
(d) a written request that includes all information relevant to the dispute to the Plan Administrator for a hearing before the appropriate administrative or regulatory body having jurisdiction over appeals on Plan matters.
L. “Producer” A licensed casualty insurance agent or broker as defined in the State Insurance Code, whose privileges under the Plan have not been suspended or revoked. Provided, however, that such producer shall, for purposes of the Plan, be considered to be acting on behalf of the insured or employer applying under the Plan and not as an agent of the Plan Administrator or of any assigned carrier for Plan business.
M. “Undisputed Premium” A workers' compensation insurance premium obligation that is not the subject of a bona fide dispute.
N. “Voluntary Offer of Coverage” A legitimate, good faith offer of workers' compensation insurance made by a workers' compensation insurer to an employer on a “voluntary” basis outside this Plan, which said offer is either: (i) of such workers' compensation insurance on a monoline basis and on a reasonable rating plan approved for use in Arkansas by the Commissioner for that insurer; or (ii) of such workers' compensation insurance in combination or coordination with other property and/or casualty coverages and limits desired by the employer and as such insurer may also offer; provided however, that such insurer shall apply its filed rating plan (including all applicable discounts or credits) to such employer in a good faith, non-discriminatory manner. “Voluntary Offer of Coverage” shall in no event be interpreted as including or referring to an offer, entreaty or opportunity presented for coverage under any type of self-insured workers' compensation plan.
Neither the Plan Administrator(s) nor the servicing carrier(s) shall have a responsibility to determine whether the putative voluntary offer of coverage is truly “voluntary”, but any agent or broker and any insurer knowingly submitting an offer of workers compensation coverage to an employer which does not meet the above definition of a bona fide “voluntary offer” may be in violation of Ark. Code Ann. §§ 23-66-205 et. seq. and Section 16.D. of this Rule and Regulation.
O. “Workers' Compensation Insurance”
(a) Statutory workers' compensation and occupational disease liability insurance including insurance for liability under the Longshore and Harbor Workers' Compensation Act, as amended, and the Federal Coal Mine Health and Safety Act of 1969, as amended;
(b) Employers liability insurance written in connection with a workers' compensation policy; and
(c) Such other coverages as approved by the Commissioner.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 054.00.54-4, AR ADC 054.00.54-4
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